Setting Quit Dates

Conventional wisdom in smoking cessation circles says that people should make plans and preparations for some unspecified future time to quit. Most people think that when others quit smoking that they must have put a lot of time into preparations and planning, setting quit dates and following stringent protocols until the magic day arrives.

When it comes down to it, this kind of action plan is rarely seen in real world quitters. I emphasize the term real world quitters as opposed to people quitting in
the virtual world of the Internet. People who seek out and participate in Internet sites do at times spend an inordinate amount of time reading and planning about their quits before taking the plunge. Even at our site we see people say they were reading here for weeks or months before finally quitting and joining up. Although I suspect there are a fair number of people who had already decided to quit right away and searched us out after their quit had begun, and some people who may not have actually decided to quit but who when finding WhyQuit.com and seeing cigarettes for what they are decided then and there to start their quits.

Getting back to real world experience though, the best people to talk to when it comes to quitting smoking are those who have successfully quit and have successfully stayed off for a significant period of time. These are people who have proven that their technique in quitting was viable considering they have quit and they are still smoke free. Talk to everyone you know who is off all nicotine for a year or longer and find out how they initially quit smoking. You will be amazed at the consistency of the answer you get if you perform that little survey.

People are going to pretty much fall into one of three categories of stories. They are:

People who awoke one day and were suddenly sick and tired of smoking. They tossed them that day and never looked back.

People who get sick. Not smoking sick, meaning some kind of catastrophic smoking induced illness. Just people who get a cold or a flu and feel miserable. They feel too sick to smoke, they may feel too sick to eat. They are down with the infection for two or three days, start to get better and then realize that they have a few days down without smoking and decide to try to keep it going. Again, they never look back and stuck with their new commitment.

People who leave a doctors office who have been given an ultimatum. Quit smoking or drop dead--it's your choice. These are people for whom some sort of problem has been identified by their doctors, who lay out in no uncertain terms that the person's life is at risk now if they do not quit smoking.

All of these stories share one thing in common -- the technique that people use to quit. They simply quit smoking one day. The reasons they quit varied but the technique they used was basically the same. If you examine each of the three scenarios you will also see that none of them lend themselves to long-term planning -- they are spur of the moment decisions elicited by some external circumstance.

I really do encourage all people to do this survey, talking to long- term ex-smokers in their real world, people who they knew when they were smokers, who they knew when they quit and who they still know as ex- smokers. The more people do this the more obvious it will become how people quit smoking and how people stay off of smoking. Again, people quit smoking by simply quitting smoking and people stay off of smoking by simply knowing that to stay smoke free that they must Never Take Another Puff!

That commentary elicited a reply from another person,
who was basically trying to give the impression that serious scientists
shouldn't put too much emphasis on real world experiences. I wrote a
reply to this editorial but it somehow did not seem to get past the
editorial review board at the British Medical Journal. I think the reply
is still valid so I am attaching it below:

"...because something commonly happens in a particular way 'in the real
world' then this should be considered the best way."

Smoking
cessation experts often seem to have to be telling people to dismiss
real world experiences. Usually I see a little different variation of
the comment above. Common statements I have seen are something to the
effects that while it is likely that a person may at times encounter
real world quitters who succeeded by using non-recommended techniques,
usually meaning no pharmaceutical intervention or in what this study is
showing, people who used no set quitting date, that these people are
just the exceptional cases. What the experts are trying to do in effect
is discredit observations made by people, making them think that the
occurrence of such experiences are really rare.

The author
above was at least accurate enough to say, "While it is true that most
smokers who quit do so without any specific behavioral support or
pharmacological treatment..." The rest of the comment was going on to
try to give the impression that there would have been even more
successful quitters if people would just do what smoking cessation
experts say should work as opposed to doing what actual quitters
continually say has worked for them.

The tactic
being employed here is to leave the impression that we could just have a
whole lot more successful quitters if people would just utilize the
miraculous effective products out there that actually help people to
quit. There is also the perception being portrayed that there really are
very few ex-smokers out there because most who have tried to quit have
done so unaided and everyone just knows how improbable it is for people
to be able to quit in an unaided attempt.

Medical
professionals and the general public are being misled to believe that
quitting smoking is just too plain difficult for people to do on their
own and that the odds of a person actually quitting on their own is
really pretty dismal.

This would
all make perfect sense if not for the fact that we have so many
successful ex-smokers in the real world. In America, we have more former
smokers than current smokers. Over half of the people who used to smoke
have now quit smoking. From the comment made above it should be clear to
all that most of the people who have quit either did not know of
professional recommendations for quitting or chose to ignore
professional intervention techniques. Yet these people successfully quit
anyway. I think that this is an important point to hit home with all
medical professionals. The medical profession has got to start to help
people to realize the real potential of success that individuals do have
to quit smoking instead of perpetuating the idea that quitting is just
too hard for an individual smoker to expect to actually succeed without
help.

While this
article should have been about planning techniques, the original author
and a few experts weighing in on the discussion have tried to turn it
into a referendum on selling pharmaceutical interventions. Nicotine
replacement products have been around for over two decades now-- and a
significant percentage of smokers have used them to try to quit smoking.
If a product has been around for decades, used by millions of people
worldwide, AND, has been truly effective, it should be easy for most
health care practitioners to come up with lots and lots of successful
patients, colleagues, family members and friends who have quit with
these products.

As I said
in my original commentary above:

" I don't
believe that there is a single professional smoking cessation "plan your
quit" advocate who will suggest other medical professionals should take
a similar survey. For if they did their study results would almost
certainly be called into question when the health care professional
starts seeing the results of his or her real life survey. The experts
will end up having to spend quite a bit of time trying to explain away
the discrepancy, using rationalizations like the people who planned
their quit "didn't do it right" or didn't "plan" long enough or were
"just more addicted smokers."

In all
honesty, I don't expect my encouraging of real world observations by
health care professionals to have much impact with smoking cessation
experts. They are going to profess to believe whatever other experts
keep telling them to believe or, what the funders of their studies
believe.

I do
however believe that health care workers who are on the front line and
actually deal with patients who smoke are going to be a bit more
critical and analytical about this. If they spend any time talking with
patients they are going to see through the rhetoric and the
rationalizations of the experts.

I have
always tried to disseminate the message that just because something
works in the lab or in study conditions doesn't necessarily translate to
the fact that the process will work in the real world. The smoking
cessation experts seem to have to work on the basis that just because
something works in the real world doesn't mean that it is a good
approach if it doesn't seem to work in a lab.

I have high
hopes that medical professionals really wanting to help their patients
are going to be more influenced by what they see is successful than by
being told by the experts what should be successful, but somehow not
replicable in their own practices.